Abstract Details

Title Difference in Outcomes in Patients with Carotid Stenting With and Without Balloon Angioplasty

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-055

Objective To compare the short-term outcomes in patients with carotid stent placement with and without balloon angioplasty.

Background Carotid artery stenting is a proven intervention in carefully selected patients to decrease risk of recurrent cerebral ischemic events(stroke/TIA) for patients with symptomatic cervical carotid artery stenosis,and balloon angioplasty either before or after stent placement is commonly performed for such patients.However,there is risk of distal embolic ischemic stroke due to manipulation of atherosclerotic plaque.Carotid stenting without balloon angioplasty may lower this risk through less procedural plaque trauma and more gradual, radial force related, vascular remodeling.

Design/Methods Consecutive patients who underwent stent placement for symptomatic cervical carotid stenosis at our institution,from February 2016 till August 2018 were included for analysis.Patients with unsuccessful stent placement and bilateral stent placement were not included in final analyses.Data were retrieved from patient records retrospectively.Demographic information (age,gender),side of carotid stenosis and stenting,pre and post procedural stenosis percentages(NASCET criteria),peri-procedural major complications(ischemic stroke,ICH,MI,death),and whenever available,date for recurrence of same sided stroke/TIA in short-term (up to 1 month) were collected.

Results

33 patients were included in final analysis.Mean age was 63.3 years(SD 13.7) (median 65). 9 (27%) were female,while 24(73%) were male patients.Left sided stenting was done in 18(54.5%) patients, while the remaining (15,45.5%) had right sided stenting.Total of 13 patients (39.4%) did not have balloon angioplasty.

	Without balloon angioplasty (n=13)	With balloon angioplasty (n=20)
Pre-procedural stenosis (Mean)	78.9%	83.4%
Post-procedural stenosis (Mean)	27% (n=8)	23% (n=4)
Peri-procedural complications	1(7.7%)	3(15%)
mRS score at discharge after stent placement (Median (IR))	1(1-4)	2(1-4)
Recurrent stroke/TIA (within 1 month)	1 of 10%(10%)	0 of 13(0%)

Conclusions

This small case series of patients treated with carotid stenting for symptomatic carotid stenosis indicates that stenting without balloon angioplasty may be associated with fewer peri-procedural major complications.Larger patients cohorts with longer term follow will be need to further investigate this observation.

Authors/Disclosures
Aakash N. Bodhit, MD (Dignity Health-St. Mary's Health Center) PRESENTER	No disclosure on file
Randall Edgell, MD	Dr. Edgell has nothing to disclose.

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